title: A new periapical index based on cone beam computed tomography.
abstract: The purpose of this study was to evaluate a new periapical index based on cone beam computed tomography (CBCT) for identification of apical periodontitis (AP). The periapical index proposed in this study (CBCTPAI) was developed on the basis of criteria established from measurements corresponding to periapical radiolucency interpreted on CBCT scans. Radiolucent images suggestive of periapical lesions were measured by using the working tools of Planimp software on CBCT scans in 3 dimensions: buccopalatal, mesiodistal, and diagonal. The CBCTPAI was determined by the largest lesion extension. A 6-point (0-5) scoring system was used with 2 additional variables, expansion of cortical bone and destruction of cortical bone. A total of 1014 images (periapical radiographs and CBCT scans) originally taken from 596 patients were evaluated by 3 observers by using the CBCTPAI criteria. AP was identified in 39.5% and 60.9% of cases by radiography and CBCT, respectively (P < .01). The CBCTPAI offers an accurate diagnostic method for use with high-resolution images, which can reduce the incidence of false-negative diagnosis, minimize observer interference, and increase the reliability of epidemiologic studies, especially those referring to AP prevalence and severity.
authors.affiliation: Federal University of Goiás, Goiânia, GO, Brazil. Electronic address: estrela3@terra.com.br.
authors.forename: Carlos
authors.initials: C
authors.lastname: Estrela
authors.affiliation: University of Cuiabá, Cuiabá, MT, Brazil.
authors.forename: Mike Reis
authors.initials: MR
authors.lastname: Bueno
authors.affiliation: Department of Dental Diagnostic Science, University of Texas, San Antonio, Texas.
authors.forename: Bruno Correa
authors.initials: BC
authors.lastname: Azevedo
authors.affiliation: Dental and Radiological Institute of Brasília, Brasília, DF, Brazil.
authors.forename: José Ribamar
authors.initials: JR
authors.lastname: Azevedo
authors.affiliation: University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Jesus Djalma
authors.initials: JD
authors.lastname: Pécora
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D054893:Cone-Beam Computed Tomography; D003753:Dental Health Surveys; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010485:Periapical Periodontitis / Q000000981:diagnostic imaging*; D011861:Radiography, Dental / Q000379:methods*; D012720:Severity of Illness Index